HEALTH PROMOTING SCHOOLS NETWORK IN LOMBARDIA REGION (ITALY) – INNOVATIVE APPROACHES TO SCHOOL-BASED HEALTH PROMOTION Liliana Coppola, Bruna Baggio, Morena Modenini, Danilo Cereda, Maria Vezzoni, Maria Gramegna

11 bilions of inhabitants Who are we? state schoolsprivate schools schools students 3-18 yr teachers92.926nd not teachers workers

Italian school system Italian health system Founding principles Universality Equality Equity Regions have the task to organize its own health system Health System in Lombardia is organized in 15 health territorial agencies (Asl) Italian school system 3-5 yr Children school 6-10 yr Primary school yr lower secondary school yr upper secondary school

Why did you choose to do this?. In Lombardy for several years, schools and health system worked together on health promotion Vilnius 2009 Guidelines IHUPE 2009 The strategy of health promotion at school has undergone a change, it is passed through more stages: - health education centered on the figure of health professional - health education centered on the figuer of teacher - in health education centered on the figure of students Nowadays these strategies are all still presents in our system. After the publication of Vilnius resolution better schools through health and Guidelines for Promoting Health in Schools (IUHPE 2009) we understood that we need a new systematic approach to health promoting at school. Schools and health territorial agencies need a guideline to work together about health promoting schools approach

School authorities and health authorities worked together to promote a health promoting school network In 2011, they signed an agreement that provides the foundation and support of a regional health promoting school network. The agreement is inspired by the Vilnius charter principles; an agreement that aims to make the Schools leaders in the governance of their own health care. What did you do? 14/7/20113/5/2012 Agreement between school authorities and health authorities Formal institution of «Health promoting schools network in Lombardia

365 schools (75 school boards) ; 1 regional school office ; 12 provincial school office 15territorial health agencies; 1 regional health office What actually happened? Who were the participants? Collaborative planning of the network (involved more than 150 teachers and health professionals): focus group, brainstorming. Contextualization of documents of the network School for Health in Europe (IUHPE) Health promoting schools network in Lombardia systemic model, integrated and scientifically based

1 Regional board School coordinator (IS dellacqua di Legnano) provincial board 1 school coordinator … 12 provincial groups provincial board 1 school coordinator provincial board 1 school coordinator provincial board 1 school coordinator School

What actually happened? The network developed a procedure (web based) to analyze health profile and health promoting interventions, schools could describe carefully their own health profile, they have to do a self-evaluation about 4 areas: individual life skills social environment school organization community collaboration. Every school could see its results and benchmark with regional or national standards. Furthermore the network organized many meetings to define its structure and many interventions to promote teachers education about: Life skills training Security at schools

Which aspects went particularly well?. Web based software ( ) is very interesting because in accordance with the new health promotion let the schools to analyze outputs and outcomes. Self evaluation data

What difficulties were encountered? The principal difficulty was the traditional view that health promotion was an activity of health professionals. To overcome this difficult, in accordance with the new model of health promotion, schools and health authorities organized many training events for teachers and health professionals to inform and educate them about the new model of health promotion.

For 2013, the network aims are: support the process of empowerment of every school in the network (nowadays more than 400 schools joined); help the schools in the network to define their health profile; contribute to the definition of improvement plans based on evidence- based interventions or best practices; spread the network by sharing evidence-based interventions and best practices with schools not belonging What will you do? After more than 1 year of life, the network continues to grow: many schools want to enter in the network School and Health authorities could work together to develop a sustainable model of health promoting school network where schools become leaders in health promoting and health system could assist them. What can we learn?

Health promoting schools network in Lombardia Region (Italy) – Innovative approaches to school-based health promotion Thank